What do you do if you have a tattoo but later want it removed? Not long ago, before the era of specialized dermatologic lasers, tattoo removal was a difficult and often unsatisfactory process. The scar left after removing the tattoo was often worse than the keeping an unsightly tattoo.
But now. while the process is not easy or painless, most tattoos can be satisfactorily “erased”. One thing is for sure—the process of removal will be more expensive and time consuming than applying the tattoo.
Typically multiple laser sessions are required, and sometimes the entire removal process will take about a year to get the proper effect. Still, laser removal is much better than the previous methods that included surgical excision (leaves a scar), vanishing creams (usually don’t work), and dermabrasion (sanding down the top layers of skin that may leave a scar and doesn’t completely remove the pigment).
When a tattoo is placed, the needle rapidly inserts many small drops of pigment into the dermis, or middle layer of the skin, and these droplets typically remain forever, although they may disperse and fade with time.
The laser works by sending a strong beam of energy to each of the pigment droplets, which heats up the pigment droplets to the point that they basically explode. When the droplets “explode”, they are broken down into many smaller pieces that the body’s immune system is capable of removing.
In the early years of dermatologic lasers, in the 1970s, doctors had only a limited number of lasers to choose from, and the early lasers used (such as the carbon dioxide laser), caused too much damage to the other elements in the skin, so they often left unacceptable scars.
The newer lasers, called “Q-switched” lasers, deliver their energy in extremely short flashes, called “pulses”. These lasers much better target the pigment, and leave the other skin elements (such as melanin pigment) mostly unharmed.
Various factors determine how well the tattoo is erased. The skill of the surgeon, the post-operative care, the natural color of the patient’s skin, are all important, but perhaps most critical is what colors were used in the tattoo. Dark colors are easier to remove, and light colors more difficult.
This is because dark pigments absorb the energy better, so they are easier to heat up and be broken by the laser. The easiest colors to remove are black, then blue, and the most difficult colors are yellow, red, and especially green.
Especially if you have a tattoo with difficult or many different colors, you want to find an experienced laser surgeon who has three different types of Q-switched lasers available: the Ruby, the Alexandrite, and the Nd:YAG lasers. These lasers are expensive to purchase, so many surgeons rent one or more of the devices for use as necessary,
The laser procedure can be painful, so many patients are given a topical anesthetic ointment at least 40 minutes before the procedure. The procedure itself doesn’t take very long (you can see a brief video of Kelly Osbourne having a tattoo lasered here), but after each session, the patient requires an interval of at least a month, and perhaps two months for the last laser session to heal. If the sessions are done too quickly, there is a higher chance of scaring.
And again, there are no guarantees that the result will be perfect, so you should not get a tattoo today and think it can be totally removed in the future. But you can increase your chances by going to an experienced tattoo artist, and choosing black or at least dark inks.
On the horizon though, to make tattoo removal simpler one day, are tattoo inks that specially made to be more easily removed by a laser. But until that time, before you get a tattoo, think in the long term.
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